Kennedy's brain surgery "successful"

Sen. Edward Kennedy successfully underwent surgery Monday in Durham, N.C., for a malignant brain tumor, his surgeon said.

Dr. Allan Friedman, who performed the surgery at Duke University Medical Center, pronounced the operation a success and said it "accomplished our goals." Up next: chemotherapy and radiation, aimed at shrinking whatever is left of the tumor.

"The main goal is to remove as much of the tumor as possible to give any other therapy that we do a better chance of working," said Dr. John Sampson, associate deputy director of Duke's brain-tumor center.

Kennedy, 76, was given a diagnosis two weeks ago for a malignant glioma in the upper left brain after suffering a seizure at a family residence on Cape Cod, Mass. His surgery followed initial treatment at Massachusetts General Hospital in Boston.

Kennedy told his wife, Victoria, immediately after the surgery, "I feel like a million bucks," a spokesman recounted.

Doctors who were not involved in Kennedy's care said it was a good sign that the tumor was considered operable.

Malignant glioma, the most common form of brain cancer, accounts for 9,000 cases that are diagnosed each year in the United States, according to the National Cancer Institute. About half the patients with the deadliest gliomas die within 15 months.

New drugs are extending survival, researchers say, and some patients live more than four years.

The decision to undergo surgery was apparently made last week. Massachusetts General, which has a top-flight neurosurgery team, did not mention surgery as an option after diagnosing the cancer May 20. Its report cited just "various forms of radiation and chemotherapy" as usual treatment.

By last Friday, the thinking had apparently changed, and Kennedy and his wife met a group of neurosurgeons from leading institutions, including the University of California, San Francisco and Duke.

Early Monday morning, Kennedy's office issued a statement saying that he expected to remain in the Duke hospital about a week and then return to Massachusetts, where he will undergo chemotherapy and radiation treatments at Massachusetts General.

It was not clear from either statement how long the chemotherapy and radiation would take or why doctors decided to move Kennedy to Duke.

Doctors who were not involved in Kennedy's care said the Brain Tumor Center at Duke had a reputation for aggressively attacking tumors while working to preserve the function of surrounding tissue, which in Kennedy's case is critical for language.

In tumor removal, the experts said, doctors at top institutions use sophisticated imaging technology to produce a precise three-dimensional image of the tumor. They put the patient under anesthesia and cut away a piece of the skull just above the tumor.

They then wake the patient, and probe the area around the tumor to see exactly which parts of the brain are crucial for normal functioning.

If the tumor is in the parietal lobe, as in Kennedy's case, doctors typically stimulate a series of points on the surface of the exposed region while having the patient speak or identify words.

That lets the surgical team map the precise areas that support language and that should be preserved. Each brain is slightly different, so each patient must be directly tested to mark the critical areas, which are often tagged with little paper markers.

The challenge for the surgeon in any such procedure is to remove as much of the tumor as possible, while avoiding sensitive areas.

"We call it debulking, and we like to get a very high percentage of the tumor, say 90 percent, which can help a lot" with overall treatment, said Dr. Robert Goodman, an associate professor of neurosurgery at Columbia University.

Material from The Associated Press is included in this report.